Provider Demographics
NPI:1760460513
Name:PEREZ-ARCE, JOSE ARMANDO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ARMANDO
Last Name:PEREZ-ARCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12685 STARKEY RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-1421
Mailing Address - Country:US
Mailing Address - Phone:727-535-9901
Mailing Address - Fax:727-535-8760
Practice Address - Street 1:12685 STARKEY RD STE 1
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-1421
Practice Address - Country:US
Practice Address - Phone:727-535-9901
Practice Address - Fax:727-535-8760
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78768207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257440300Medicaid
FLE3164Medicare ID - Type Unspecified
FLH04909Medicare UPIN